Shock: Lab Test

1st order laboratory parameters – obligatory laboratory tests.

  • Small blood count [Hb (hemoglobin) and hematocrit (Hk) are unsuitable for estimating current blood loss!]
  • Inflammatory parameters – CRP (C-reactive protein) or PCT (procalcitonin).
  • Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, urobilinogen, bilirubin, blood), sediment, if necessary urine culture (pathogen detection and resistogram, that is, testing suitable antibiotics for sensitivity / resistance).
  • Electrolytescalcium, chloride, potassium, magnesium, sodium, phosphate.
  • Fasting glucose (fasting blood glucose).
  • Blood gas analysis (ABG) – for circulatory instability/shock; determination of:
    • Venous: pH, BE. (Lactate) [Lactate ↑ = oxygen deficiency due to inhibition of aerobic glycolysis]
  • Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH) and gamma-glutamyl transferase (gamma-GT, GGT), alkaline phosphatase, bilirubin.
  • Renal parameters – urea, creatinine, cystatin C or creatinine clearance, if necessary.
  • Coagulation parameters – PTT, Quick

Laboratory parameters 2nd order – depending on the results of the history, physical examination and mandatory laboratory parameters – for differential diagnostic clarification.

  • Blood culture or blood cultures (without delay) – if septic shock is suspected.
  • Tryptase (mast cell tryptase) – if anaphylactic shock is suspected [values 20-200 μg/l; decrease to normal within 24-48 hours].
  • Toxicological tests – in case of suspected intoxications.
  • Thyroid parameters – TSH